[Evaluation of the analgesic effectiveness of ketorolac in intravenous regional anesthesia induced by lidocaine].
OBJECTIVE
Intravenous regional anesthesia (i.v.r.) is a safe, effective technique for surgery on the upper extremities, but it provides no postoperative analgesia. The aim of this study was to evaluate the analgesic efficacy of ketorolac during and after surgery with i.v.r. induced by lidocaine.


METHODS
A double blind, placebo-controlled clinical trial. Twenty-six patients undergoing elective surgery on the upper extremities under i.v.r. were studied. In the anteroom of the operating theater, an anesthesiologist prepared the anesthetic solution to be administered from two syringes. One contained 3 mg/kg of 0.5% lidocaine (0.6 ml/kg). The second syringe (2 ml) contained 1 ml of 0.9% saline solution for the control group or 1 ml with 30 mg of ketorolac for the treatment group. A second anesthesiologist received the patient in the operating theater and used the syringes provided to induce the blockade. After releasing the pneumatic tourniquets we assessed the appearance of postoperative pain on a visual analog scale over the first 24 hours. The dats were compared using parametric (Student t test) and non parametric tests (Mann-Whitney U test and Fisher's exact test).


RESULTS
No significant differences in the characteristics or hemodynamic parameters analyzed were found between the two groups. Nor did we find any differences in analgesia during surgery. Ten of the 13 patients (77%) in the control group required analgesia within the first two hours, whereas none of the patients in the treatment group required analgesia during that time (p < 0.0001). There were no statistically significant differences between the two groups in the total amount administered altogether, both during and after surgery. No local or systemic side effects were observed.
Arregui-Martínez de Lejarza
L M
LM
Sección de Anestesia, Hospital El Escorial, San Lorenzo de El Escorial, Madrid.
Vigil
M D
MD
Pérez Pascual
M C
MC
Cardona-Valdés
A
A
Pérez de Cossío
J M
JM
D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects / Q000627:therapeutic use*; D000765:Anesthesia, Conduction; D000771:Anesthesia, Intravenous; D000779:Anesthetics, Local; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D020910:Ketorolac; D008012:Lidocaine; D008297:Male; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy; D014046:Tolmetin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D018712:Analgesics, Non-Narcotic; D000779:Anesthetics, Local; D008012:Lidocaine; D014046:Tolmetin; D020910:Ketorolac
Evaluación de la eficacia analgésica del ketorolaco en la anestesia regional intravenosa inducida con lidocaína.